464 Main Street Operations LLC
Skilled Nursing Facility in Agawam, Massachusetts
1699957415- Practice location
- 464 Main St, Agawam, MA 01001-1826
- Phone
- 412-786-8000
- Fax
- 413-789-1099
- Last updated
- October 23, 2020
464 Main Street Operations LLC is a healthcare organization based in Agawam, MA. 464 Main Street Operations LLC practices in Agawam, MA. The NPI Number for 464 Main Street Operations LLC is 1699957415 and holds a License No. 0875 (MA). The current practice location address for 464 Main Street Operations LLC is 464 Main St, Agawam, MA 01001-1826 and can be reached out via phone at 412-786-8000 and via fax at 413-789-1099.
Provider Profile Details
- NPI Number
- 1699957415
- Provider Name
- 464 Main Street Operations LLC
- Provider Entity Type
- Organization
- Address
- 464 Main St, Agawam, MA 01001-1826
- Phone Number
- 412-786-8000
- Fax Number
- 413-789-1099
- Primary Taxonomy
- Skilled Nursing Facility · 314000000X
- Organization Subpart
- No
- Authorized Official
- Michael T Berg · Asst Secretary · 505-468-4742
- Other Names
- Memory Support Of Heritage Hall (Doing Business As)
- Provider Enumeration Date
- December 4, 2007
- Last Update Date
- October 23, 2020
- Certification Date
- October 23, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 464 Main St
Agawam, MA 01001-1826 - City
- Agawam
- State
- Massachusetts
- Zip
- 01001-1826
- Phone Number
- 412-786-8000
- Fax Number
- 413-789-1099
Provider Business Mailing Address Details
- Address
- 101 E State St
Kennett Square, PA 19348-3109 - City
- Kennett Square
- State
- PA
- Zip
- 19348-3109
- Phone Number
- 610-925-4436
- Fax Number
- 610-925-4351
License Information
- License Number
- 0875
- License State
- MA
- Taxonomy
- Skilled Nursing Facility · 314000000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of 464 Main Street Operations LLC?
The NPI number of 464 Main Street Operations LLC is 1699957415. It was assigned on December 4, 2007 and is currently active in the NPPES registry.
What is the specialty of 464 Main Street Operations LLC?
464 Main Street Operations LLC is registered under the primary taxonomy Skilled Nursing Facility (code 314000000X), licensed in MA under license number 0875.
Where does 464 Main Street Operations LLC practice?
The practice location is 464 Main St, Agawam, MA 01001-1826. The office can be reached at 412-786-8000 (phone) or 413-789-1099 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1699957415 directly on the NPPES registry website.